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Geriatr Gerontol Int. 2018 May;18(5):758-766. doi: 10.1111/ggi.13248. Epub 2018 Jan 22.

Resident and facility characteristics associated with care-need level deterioration in long-term care welfare facilities in Japan.

Author information

1
Department of Health Services Research, Graduate School of Comprehensive Human Sciences, Tsukuba, Japan.
2
Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
3
Faculty of Political Science and Economics, Waseda University, Tokyo, Japan.
4
Research Managing Director, National Institute of Public Health, Saitama, Japan.

Abstract

AIM:

To determine the resident and facility characteristics associated with residents' care-need level deterioration in long-term care welfare facilities in Japan.

METHODS:

A nationally representative sample of 358 886 residents who lived in 3774 long-term care welfare facilities for at least 1 year from October 2012 was obtained from long-term care insurance claims data. Facility characteristics were linked with a survey of institutions and establishments for long-term care in 2012. We used a multilevel logistic regression according to the inclusion and exclusion of lost to follow-up to define the resident and facility characteristics associated with resident care-need level deteriorations (lost to follow-up: the majority were hospitalized residents or had died; were treated as deterioration in the including loss to follow-up model).

RESULTS:

Adjusting for the covariates, at the resident level, older age and lower care-need level at baseline were more likely to show deterioration in the care-need level. At the facility level, metropolitan facilities, unit model (all private room settings) and mixed-model facilities (partly private room settings) were less likely to experience care-need level deterioration. A higher proportion of registered nurses among all nurses was negatively related to care-need level deterioration only in the model including lost to follow-up. A higher proportion of registered dietitians among all dietitians and the facilities in business for fewer years were negatively associated with care-need level deterioration only in the model excluding lost to follow-up.

CONCLUSIONS:

The present study could help identify residents who are at risk of care-need level deterioration, and could contribute to improvements in provider quality performance and enhance competence in the market. Geriatr Gerontol Int 2018; 18: 758-766.

KEYWORDS:

care-needs; functional decline; multilevel analysis; nursing homes; quality of care

PMID:
29356311
DOI:
10.1111/ggi.13248
[Indexed for MEDLINE]

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